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Biomedical subjects

F J Muñoz-Negrete

Publications and source records attributed to F J Muñoz-Negrete.

At least 19 recordsLinked to original sources
PubMed2006

Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement.

PURPOSE: To determine agreement between slit-lamp indirect ophthalmoscopy and Stratus optical coherence tomography (OCT) when assessing cup-to-disc ratios (CDRs). METHODS: Twenty-five ocular hypertensive subjects and 56 patients with primary open-angle glaucoma were included. Estimation of vertical (VCDR) and horizontal (HCDR) cup-to-disc ratio with slit-lamp ophthalmoscopy was made by three glaucoma specialists along with OCT scanning of optic nerve head. Agreement between OCT and specialists was measured by intraclass correlation coefficients (ICC), Bland and Altman's scatterplots, and a regression coefficient of the average difference. RESULTS: The mean VCDR and HCDR was significantly higher (P<0.001) with OCT than that estimated by the specialists, with the difference ranging from 0.08 to 0.11, and from 0.13 to 0.18, respectively, depending on the specialist. Difference was higher (P<0.001) for cuppings below 0.3, and looses significance for larger VCDR cuppings (above 0.7). ICC for VCDR was 0.87 among specialists, and ranges from 0.82 to 0.75 when comparing OCT and specialists. ICC for HCDR was 0.83 among specialists and 0.74 between OCT and specialists. When data were plotted according to the Bland-Altman method, as the cupping increased, the agreement also increased. CONCLUSIONS: There is very good agreement among the specialists when estimating CDRs by stereoscopic slit-lamp biomicroscopy. OCT shows higher values than the specialists; the greatest differences occurred when assessing small CDRs and the differences diminished as the cupping increased. These two methods of measurement are not interchangeable, and the difference must be considered, especially in discs with smaller CDRs.

Early Diagnosis↗
PubMed2006

[Ultrasound biomicroscopy in deep sclerectomy with a new acrylic implant].

OBJECTIVE: To describe the ultrasound biomicroscopic (UBM) characteristics seen in patients who have undergone deep phaco-sclerectomy with a new acrylic implant (Esnoper). SUBJECTS, MATERIAL AND METHODS: UBM exploration was performed 12 months after deep phaco-sclerectomy in three patients with chronic open angle glaucoma. RESULTS: One year after surgery, all three patients had intraocular pressure levels under 15 mmHg and were on no treatment. All of them had an intrascleral space in UBM, in which the hyperechogenic implant was visible. CONCLUSIONS: The new non-absorbable implant has proven to be effective in these cases. Information provided by UBM is useful and assists in understanding the mechanism of action of deep sclerectomy.

Acrylic Resins↗
PubMed2005

Deep sclerectomy with mitomycin C in failed trabeculectomy.

AIM: To evaluate the success rate and complications associated with deep sclerectomy with mitomycin C (MMC) and a reticulated hyaluronic acid implant in previously failed trabeculectomy. METHODS: This prospective study included 20 eyes with a previously failed trabeculectomy, which were treated with deep sclerectomy with 0.2 mg/ml MMC application under the conjunctiva and superficial scleral flap. Intraocular pressure (IOP), glaucoma medications, visual acuity, and complications were recorded preoperatively and 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. RESULTS: The mean preoperative IOP was 25.8+/-7.3 mmHg; the IOP significantly decreased to 14.6+/-3.2 mmHg 1 year postoperative. At each interval, the mean IOP was significantly lower than preoperatively (P=0.000). At 1 year, the complete success rate (IOP<or=21 mmHg untreated) was 65% and the qualified success rate (IOP<or=21 mmHg with and without medication) was 100%. 12 patients (60%) achieved an IOP<or=15 mmHg with and without medication. No shallow or flat anterior chamber, endophthalmitis, or leakage developed. CONCLUSIONS: These data suggest that deep sclerectomy augmented with MMC is a safe surgical procedure that decreases IOP in eyes with a previously failed trabeculectomy.

Aged↗
PubMed2005

[SCA-7. Cone-rod dystrophy in the context of an hereditary ataxia].

CLINICAL CASE: A 21-year-old male presented with bilateral loss of visual acuity within the last year, and cerebellar ataxia since childhood. Two members of his family had a similar disorder. Examination showed bilateral central scotomas, as well as an electroretinogram pattern and optic coherence tomography images consistent with cone-rod dystrophy. Molecular analysis by PCR amplification and genotyping of the SCA7 gene established the diagnosis of SCA-7. DISCUSSION: SCA-7 is a polyglutamine expansion disorder and the only spinocerebellar ataxia that shows a cone-rod dystrophy phenotype, which probably results from interference with the action of specific cone-rod genes.

Adult↗
PubMed2004

[IOP spikes following contact transscleral diode laser cyclophotocoagulation].

PURPOSE: To evaluate the incidence of intraocular pressure (IOP) spikes after contact transscleral diode laser cyclophotocoagulation (cyclodiode) and to identify related risk factors. METHOD: Retrospective study of 116 eyes (110 patients) with refractory glaucoma who underwent cyclodiode. IOP measurement was obtained immediately before and one hour after cyclodiode. We defined an IOP spike as an increase equal or superior to 5 mmHg after laser treatment. We evaluated several potential pre-, intra- and post-operative factors related to the IOP spike occurrence. RESULTS: Mean IOP decreased one hour after cyclodiode 6.96 mmHg (SD: 8.36) (p<0.001). Overall, we observed 10.8% of IOP spikes. Age, sex, mean energy delivered, pop occurrence and iris colour were not associated with the postoperative IOP spike occurrence. The percentage of IOP spikes was higher in neovascular glaucoma (p=0.074). The IOP spike rate was also higher after retreatment, but the difference compared to the eyes which underwent cyclodiode for the first time was not significant. CONCLUSIONS: These preliminary results suggest that IOP spike prevention could be considered in neovascular glaucoma scheduled for cyclodiode

Aged↗
PubMed2003

[Frequency doubling perimetry in terminal visual field defects].

PURPOSE: To evaluate the Frequency Doubling Technology (FDT) in end-stage glaucomatous visual field defects. METHODS: FDT (C-20 threshold test) was performed in 22 consecutive patients presenting an end-stage visual field defect with 24-2 SITA (0 dB in more than 75% and less than 100% of the visual field). Comparisons of the percentage of non-abolished points, topographic correlation, test duration and global indexes were performed between C-20 and 24-2 SITA test. RESULTS: FDT sensitivity was 100%. C-20 test showed 13.7% more points with sensitivity greater than 0 dB compared to 24-2 test (P = 0.002). Two and a half less minutes were required for C-20 test performing (P<0.001). The mean value of Mean Defect was 11.48 dB better in FDT (P = 0,000). The mean value of the Pattern Standard Deviation was 5.37 dB (SD: 1.92) and 6.35 dB (SD: 3.61) for 24-2 and C-20 test respectively (P = 0.258). The inferotemporal quadrant was the best conserved in both perimetric strategies (Kappa agreement test value = 0.911; P<0.001). CONCLUSIONS: FDT showed greater ability than 24-2 test for end-stage visual field defects evaluation, with the advantage of being less time-consuming. Very good topographic correlation between both strategies was found. Further studies evaluating FDT reproducibility in severe glaucomatous visual field damage are necessary.

Adult↗
PubMed2003

[Ultrasonic biomicroscopic findings after spontaneous resolution of a traumatic cyclodialysis].

CASE REPORT: We present one patient that received a blunt trauma in his right eye that resulted in ocular hypotension and hypotony maculopathy. UBM demonstrated the presence of a cyclodialysis. Several months later the patient experienced spontaneous improvement. A new UBM documented the presence of an anterior synechia closing the cleft. DISCUSSION: Ciclodyalisis is an infrequent problem. There are several treatment options, including conservative treatment, laser cyclopexy or surgical cyclopexy. Sometimes an spontaneous closure of the cleft may occur.

Adult↗
PubMed2003

[Extender-tube for Ahmed glaucoma valve implant].

CASE REPORT: We describe the case of a 16 year-old woman, with inflammatory glaucoma secondary to juvenile rheumatic arthritis, successfully treated by Ahmed glaucoma valve implant. Two years later, a severe increase of intraocular pressure related to anterior tube migration occurred. The Ahmed valve tube extender was successfully used to lengthen the tube. DISCUSSION: If the tube length is too short to reintroduce it into the eye, there are three surgical options: to use a tube extender, to insert the tube via the pars plana or to insert a new drainage implant. A piece of an angiocatheter or a silastic tube have been used for lengthening the tube of the valve implant; however the Ahmed valve tube extender design makes surgery easier and allows keeping the valve in the original place, minimizing the risk of postoperative migration.

Adolescent↗
PubMed2001

Topical plus intracameral lidocaine versus retrobulbar anesthesia in phacotrabeculectomy: prospective randomized study.

PURPOSE: To compare the efficacy and safety of topical and retrobulbar anesthesia for phacotrabeculectomy. SETTING: Hospital Ramón y Cajal, Madrid, Spain. METHODS: This prospective study comprised 60 patients (60 eyes) having phacotrabeculectomy surgery. Patients were randomly assigned to 1 of 2 groups receiving topical anesthesia plus intracameral lidocaine 1% or retrobulbar anesthesia. Patients were asked to document the discomfort they experienced during the administration of the anesthetic agent, during surgery, and postoperatively using a numeric pain scale. Complications and surgical conditions were also evaluated. RESULTS: The retrobulbar group reported significantly more discomfort during administration of the anesthetic agent than the topical group (P < .001). The topical group reported significantly more discomfort intraoperatively (P < .01). Eyelid squeezing and eyeball movement were more common in the topical group; however, neither was a problem to the surgeon. There was no difference in surgical conditions (P = .38) or the postoperative pain scores between the 2 groups (P = .06). One patient receiving topical anesthesia developed a suprachoroidal hemorrhage intraoperatively. CONCLUSIONS: Topical anesthesia supplemented with intracameral lidocaine was an effective alternative to retrobulbar anesthesia for phacotrabeculectomy. Although the degree of patient discomfort was significantly higher during surgery under topical anesthesia, the method avoids the pain and complications associated with a retrobulbar injection.

Administration, Topical↗
PubMed2001

[Glaucoma related with photoreceptor outer segments in aqueous humor. Schwartz-Matsuo syndrome].

CASE REPORT: We present the case of a patient who was initially diagnosed of hypertensive uveitis with marked fluctuation that was resistant to the common treatment. After a systematic examination, retinal detachment of the ora serrata in the inferotemporal quadrant was diagnosed. The sample of aqueous humor showed melanic pigment and degenerated photoreceptor outer segments. After retinal detachment surgery, the intraocular pressure returned to normal levels without antiglaucoma medication. DISCUSSION: The presence of photoreceptor outer segments in aqueous humor confirms the diagnosis of Schwartz-Matsuo syndrome, which should be considered as a differential diagnosis of iritis and glaucoma.

Adult↗
PubMed2001

[Neuroretinitis in an HIV-infected patient].

CASE REPORT: We present a 35 year-old man, suffering from HIV infection with a left neuroretinitis and bilateral multifocal inner retinitis. A systematic approach supported the presumed diagnosis of cat-scratch disease. The patient was treated with oral azytromicine following a full-clinical recovery. DISCUSSION: We discuss the differential diagnosis of this clinical entity, treatment and clinical evolution.

Adult↗
PubMed2001

[Intra-bleb pigmentation after phacoemulsification].

CASE REPORT: We report the finding of an intense intra-bleb pigmentation 24 hours after uncomplicated phacoemulsification in an eye with previous trabeculectomy. In the follow-up, considerable reduction in degree of pigmentation was observed and intraocular pressure remained under control without medication. DISCUSSION: Intra-bleb pigmentation after trabeculectomy or phacotrabeculectomy has been recently reported by Wanichwecharungruang; however it has never been mentioned after isolated phacoemulsification. It is usually related with intraoperative pigment dispersion. A preexisting thin bleb provides a clear view of intra-bleb pigmentation, that appears associated with a successful filtration.

Aged↗
PubMed2000

[Diabetic papillopathy and type 2 diabetes].

CASE REPORT: We report a case of a 62-year-old man with type II diabetes mellitus and mild impairment of visual acuity with bilateral optic disc edema. Visual field examination showed enlargement of right blind spot and an inferior arcuate defect in the left eye. Blood pressure, neuroimaging evaluation and cerebrospinal fluid analysis were normal. Spontaneous resolution was observed six weeks later. DISCUSSION: Although the diabetic papillopathy was initially described in juvenile diabetics, recently an afflicted older subpopulation with type II diabetes has been reported to develop this condition. We discuss the clinical characteristics, pathogenesis and differential diagnosis of this clinical entity.

Diabetes Mellitus, Type 2↗
PubMed2000

[Intraocular pressure evolution after phacoemulsification in eyes with filtering blebs].

PURPOSE: To evaluate the effect of phacoemulsification in functioning filtered glaucoma eyes, on intraocular pressure (IOP) and the use of antiglaucomatous medication. To determine the influence of time lapsed between surgeries on the results. METHOD: 20 eyes of 20 patients treated by phacoemulsification in 1997, who had undergone previous glaucoma filtering surgery in which IOP was well controlled, were retrospectively evaluated. RESULTS: Mean preoperative IOP was 13.2+/-4.1 mmHg (range: 5-21). Mean IOP increased after phacoemulsification in every postoperative control (0.9-2.6 mm Hg), the differences were not significant. Mean score medication increased (0.2-1) after surgery, but the difference was not significant. Mean preoperative IOP was 5.7 mm Hg lower in patients whose phacoemulsification was performed before 18 months after trabeculectomy than those whose surgery was performed later (P<0.001). Moreover, the patients operated earlier showed an IOP increase after phacoemusification (3.2-3.9 mm Hg) during the first six postoperative months (P<0.05). However, the patients who underwent filtering surgery later, did not show any significant change in postoperative IOP. Visual acuity (VA) significantly improved after cataract surgery (P<0.05). VA was equal or better than 0.5 in 43.75% of the patients, six months postoperatively. CONCLUSIONS: We have found a slight increase in IOP after phacoemulsification in filtered glaucoma eyes. To reduce the time lapsed between trabeculectomy and phacoemulsification could be a risk factor predisposing to failure of previously functioning filtering blebs.

Aged↗